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Hypofractionated hi...
Hypofractionated high-energy proton-beam irradiation is an alternative treatment for WHO grade I meningiomas
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- Vlachogiannis, Pavlos (författare)
- Uppsala universitet,Neurokirurgi
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- Gudjonsson, Olafur (författare)
- Uppsala universitet,Neurokirurgi
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- Montelius, Anders (författare)
- Uppsala universitet,Medicinsk strålningsvetenskap
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- Grusell, Erik (författare)
- Uppsala universitet,Medicinsk strålningsvetenskap
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- Isacsson, Ulf (författare)
- Uppsala universitet,Medicinsk strålningsvetenskap
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- Nilsson, Kristina, 1967- (författare)
- Uppsala universitet,Experimentell och klinisk onkologi
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- Blomquist, Erik (författare)
- Uppsala universitet,Experimentell och klinisk onkologi
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(creator_code:org_t)
- 2017-10-24
- 2017
- Engelska.
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Ingår i: Acta Neurochirurgica. - : Springer Science and Business Media LLC. - 0001-6268 .- 0942-0940. ; 159:12, s. 2391-2400
- Relaterad länk:
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https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Radiation treatment is commonly employed in the treatment of meningiomas. The aim of this study was to evaluate the effectiveness and safety of hypofractionated high-energy proton therapy as adjuvant or primary treatment for WHO grade I meningiomas. A total of 170 patients who received irradiation with protons for grade I meningiomas between 1994 and 2007 were included in the study. The majority of the tumours were located at the skull base (n = 155). Eighty-four patients were treated post subtotal resection, 42 at tumour relapse and 44 with upfront radiotherapy after diagnosis based on the typical radiological image. Irradiation was given in a hypofractionated fashion (3-8 fractions, usually 5 or 6 Gy) with a mean dose of 21.9 Gy (range, 14-46 Gy). All patients were planned for follow-up with clinical controls and magnetic resonance imaging scans at 6 months and 1, 2, 3, 5, 7 and 10 years after treatment. The median follow-up time was 84 months. Age, gender, tumour location, Simpson resection grade and target volume were assessed as possible prognostic factors for post-irradiation tumour progression and radiation related complications. The actuarial 5- and 10-year progression-free survival rates were 93% and 85% respectively. Overall mortality rate was 13.5%, while disease-specific mortality was 1.7% (3/170 patients). Older patients and patients with tumours located in the middle cranial fossa had a lower risk for tumour progression. Radiation-related complications were seen in 16 patients (9.4%), with pituitary insufficiency being the most common. Tumour location in the anterior cranial fossa was the only factor that significantly increased the risk of complications. Hypofractionated proton-beam radiation therapy may be used particularly in the treatment of larger World Health Organisation grade I meningiomas not amenable to total surgical resection. Treatment is associated with high rates of long-term tumour growth control and acceptable risk for complications.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Nyckelord
- Meningioma
- Benign meningioma
- Proton beam irradiation
- Hypofractionation
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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